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General NPI Number Information
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NPI Number | 1194807420
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Entity Type | Organization
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Legal Business Name | TRI-LIFE CENTER L.L.P.
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 2401 ELK DR
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City | MINOT
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State | ND
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Zip | 58701-5631
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Country | US
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Telephone | 701-837-5433
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Fax | 701-837-5433
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Provider Business Mailing Address
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Address Line | PO BOX 2023
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City | MINOT
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State | ND
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Zip | 58702-2023
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Country | US
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Telephone | 701-837-5433
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Fax | 701-837-5434
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Authorized Official
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Title or Position | CENTER DIRECTOR
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Name | MS. BONNIE K. SJOL
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Credential | RNC
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Telephone | 701-837-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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